The long term objectives of this project are to elucidate the role of red blood cells (RBCs), hemoglobin (Hb), and nitric oxide (NO) in modulating pulmonary blood flow at the microvascular and macrovascular levels, and to thereby provide insight into the mechanisms by which RBCs affect pulmonary gas exchange. The knowledge gained from this project will have health-related ramifications, in that it will allow more informed understanding and treatment of anemia, a common accompaniment of illness, and ultimately lead to improvements in patient care through the optimization of transfusion strategies and the development of hemoglobin-based oxygen carriers. Dr. Deem has previously described the importance of RBCs in augmenting hypoxic pulmonary vasoconstriction through inactivation of NO by Hb, and has delineated the enhancement of pulmonary gas exchange by anemia under certain conditions. The current project will build on these findings in the following Specific Aims: I. Determine whether NO that is "biopreserved in the form of the oxidation product nitrite, or the NO-Hb products nitrosyl(heme)Hb and S-nitrosoHb can be released in the pulmonary circulation and result in vasodilation. The effect of these products on pulmonary artery pressure and NO production will be studied during normoxic and hypoxic conditions in an isolated, perfused rat lung model and in anesthetized rats. In addition, this aim will explore whether encapsulation of Hb within the red blood cell membrane alters the vasoactive properties of NO-Hb products. II. Determine the role of RBCs in determining microvascular hemodynamics using intravital microscopy in isolated, perfused rat lungs. This Aim will directly explore the rheology of the pulmonary microcirculation, help determine whether the RBC plays an active or passive role in determining pulmonary microvascular hemodynamics, and provide insights into the mechanisms by which RBCs alter pulmonary blood flow distribution and gas exchange.